Ok got a call from my Onc about the blood work done on Friday and normally during my treatments my CEA levels have been running from .9 to 1.2 and he tells me that my last blood work it is 10.6........ Which he says he feels there is active cancer and I need to be treated with a new chemo but I don't need to ruin my holidays and can wait until January. So now I am worried about this. Is that what it means when your CEA level goes up or could it mean anything else because unless we do a biopsy there is no way to say for sure it is cancer so I am confused at what I should be doing or if there is something else to look for or what. I will be going on 5fu and Irinotecan..........thanks

I'm assuming CEA has been a good marker for you? Of course you can always hope for a lab error, and you should have another test just to confirm it has jumped. For me, after the CEA jumps, we do a PETscan...which usually confirms the beast is back. I'll be joining the January FOLFIRI gang since I am glowing and my numbers are up. -Ashlee

I don't know if it's been a good marker because until I went to the Onc for my second opinion my local Onc never mentioned it but I looked back at my labs and saw that when I had blood drawn that sometimes the CEA was .9 and other times it was 1.2 so I didn't even know about them.........Rick.......yes when I had the CT scan last Thursday there was a dark spot on the scan that they couldn't identify but thought it might be cancer as when my liver was resected in March they couldn't get a clear margin on one side and so I had 7 more treatments of 5fu,oxy,avastan & lucovorin?sp.......

Since you're going to be waiting through the new year (and I agree with that sentiment), perhaps the best way to proceed would be another CEA reading just before you plan on going back on treatment to confirm an anomoly/illness/inflamation/lab error. If that CEA is elevated further, it's more than likely cancer; if it's stable, there are more questions to answer (maybe another CT and/or biopsy); if it's decreased, anomoly/illness/etc might be the cause.

11/13/09 5cm Stage IV 9/25 lymph nodes w/2cm peritoneal met at 29 YoA12/15/09 LA right hemi-colectomy6/16/10 Folfox FINISHED8/10/10 Prophylactic HIPEC10/9/10 got Married Still NED and living life to the fullest

Just to add in here from the Canadian perspective (BC anyway), no, they won't always do CEA under active treatment BUT, it and other markers can be used to monitor treatment trends if they are valid for that patient. They never were for me, but we did them anyway and they stayed low even during treatment (however they were also low with a bleeding rectal primary tumour hanging out in my back door ! ).

Secondly, also a yes to Fletch...the first thing they do here with any increase is repeat a CEA in 3-4 weeks. If still up, proceed to other diagnostics.

Third, and we haven't had this much lately, but have had lots of discussion about the changeover in CEA testing and reporting techniques a while ago. So if your prior CEA was done under the old system the values will be lower than the values tested under the new system. Added to that, the Canadian guidelines were altered to bring values in line with the WHO values...so there are other issues affecting exact valuations.

Fourth (sorry didn't mean to get this longwinded ) docs will generally monitor trends not just one value and MUST always take that info back to the individual patient situation, one size does NOT fit all, and they should be treating the patient...not the lab result.

Finally...lab error. It does happen. It needs to be ruled out.Hope that helped a bit cinnamongirl56 ??I think we can add a new term here CEAnxiety to scanxiety but it is better IMO that they are looking seriously at anything which could give them a heads up on needing more info or treatments. Remember there are still a number of other things which cause CEA increases, so "false positives" in the CRC monitoring sense are common.

One breathe at a time, sometimes what we have to do best !

CheersCRguy

Caregiver twiceStage IV A rectal cancer/lung met9 Year survivormy life is an ongoing NONrandomized UNcontrolled experiment with N=1 !Review of my Journey so far

I am not in active treatment right now the plan is to start treatment again in January but since I have had more time to think about this I am going to ask my Onc at JH about waiting 4-6 weeks and redo CT and Labs before going on the new treatment. The reason for this is because when we discussed options before we had my results I asked what the plan would be if CEA is NOT elevated and he said we would wait about 6 wks scan and do labs again and if it stayed that way we would wait and scan again. So if the plan is for me to start treatment about the second week in January then I will have waited 4-5 weeks anyway so why not check the CEA again to see if it was a fluke or lab error...........By the way I go next Tuesday to my local Oncologist for a port flush and labs so I am going to be very interested in seeing what my CEA will be then. Thanks for the info..........

CRguy, I guess I missed the discussion about the changeover in CEA testing and reporting techniques can you tell me where I can find the discussion I would be very interested in reading about that. I didn't realize there were old and new systems..........

CRguy wrote:Secondly, also a yes to Fletch...the first thing they do here with any increase is repeat a CEA in 3-4 weeks. If still up, proceed to other diagnostics.

Also it sounds like that some of your Onc do other things when your CEA are up and I like that idea because if I don't need the chemo yet I would prefer to wait.What other diagnostics do they try?Again thank you all.

cinnamongirl56 wrote:Livelife what is CA 19.9 ?? I don't think I have seen this before.

CA19.9 is a carbohydrate antigen that can be expressed by carcinomas of the gastro tract. It is probably most commonly found in pancreatic cancers but can be used to monitor cancer activity for CRC. Normal levels are below 37U/ml

It is used commonly in Australia to monitor treatment progress if your cancer is sensitive to it. In my case, the trend is almost identical to CEA so it is good to have 2 tumour markers to watch as well as LDH for general inflammation.